Analysis of Clinical Features in Novel Coronavirus Pneumonia Convalescents

Background:To analyze the clinical features of convalescent individuals with novel coronavirus-infected pneumonia(novel coronavirus pneumonia)at rehabilitation station in Wuhan.Methods:712 patients in the convalescence period of novel coronavirus pneumonia isolated and observed at the rehabilitation station were investigated by collecting their basic data,clinical syndrome features,and tongue manifestations.The clinical syndrome features were analyzed based on guidelines of Diagnosis and Treatment Plan for Novel Coronavirus-infected Pneumonia(National Health Commission of the People’s Republic of China,7th Trial Edition).Results:Cough(24.86%),chest tightness and shortness of breath(23.17%),and fatigue(16.57%)were the main symptoms of patients in the convalescence period of novel coronavirus pneumonia.Their tongue appearance was mostly characterized by redness(88.65%),thick coating(67.25%),greasy coating(49.78%)and white coating(76.86%).Conclusion:Compared with the ordinary/mild patients,cough and anorexia symptoms were more common in the severe/critical patients.In convalescent patients,red and fat tongue with thick greasy fur were common.

Neutralization against SARS-CoV-2 Delta/Omicron variants and B cell response after inactivated vaccination among COVID-19 convalescents

Emerging SARS-CoV-2 variants have made COVID-19 convalescents susceptible to re-infection and have raised concern about the efficacy of inactivated vaccination in neutralization against emerging variants and antigen-specific B cell response.To this end,a study on a long-term cohort of 208 participants who have recovered from COVID-19 was conducted,and the participants were followed up at 3.3(Visit 1),9.2(Visit 2),and 18.5(Visit 3)months after SARS-CoV-2 infection.They were classified into three groups(no-vaccination(n=54),one-dose(n=62),and two-dose(n=92)groups)on the basis of the administration of inactivated vaccination.The neutralizing antibody(NAb)titers against the wild-type virus continued to decrease in the no-vaccination group,but they rose significantly in the one-dose and two-dose groups,with the highest NAb titers being observed in the two-dose group at Visit 3.The NAb titers against the Delta variant for the no-vaccination,one-dose,and two-dose groups decreased by 3.3,1.9,and 2.3 folds relative to the wild-type virus,respectively,and those against the Omicron variant decreased by 7.0,4.0,and 3.8 folds,respectively.Similarly,the responses of SARS-CoV-2 RBD-specific B cells and memory B cells were boosted by the second vaccine dose.Results showed that the convalescents benefited from the administration of the inactivated vaccine(one or two doses),which enhanced neutralization against highly mutated SARS-CoV-2 variants and memory B cell responses.Two doses of inactivated vaccine among COVID-19 convalescents are therefore recommended for the prevention of the COVID-19 pandemic,and vaccination guidelines and policies need to be updated.

Characterization of oral and gut microbiome and plasma metabolomics in COVID-19 patients after 1-year follow-up

Background:Due to the outbreak and rapid spread of coronavirus disease 2019(COVID-19),more than 160 million patients have become convalescents worldwide to date.Significant alterations have occurred in the gut and oral microbiome and metabonomics of patients with COVID-19.However,it is unknown whether their characteristics return to normal after the 1-year recovery.Methods:We recruited 35 confirmed patients to provide specimens at discharge and 1 year later,as well as 160healthy controls.A total of 497 samples were prospectively collected,including 219 tongue-coating,129 stool and 149 plasma samples.Tongue-coating and stool samples were subjected to 16S rRNA sequencing,and plasma samples were subjected to untargeted metabolomics testing.Results:The oral and gut microbiome and metabolomics characteristics of the 1-year convalescents were restored to a large extent but did not completely return to normal.In the recovery process,the microbial diversity gradually increased.Butyric acid-producing microbes and Bifidobacterium gradually increased,whereas lipopolysaccharideproducing microbes gradually decreased.In addition,sphingosine-1-phosphate,which is closely related to the inflammatory factor storm of COVID-19,increased significantly during the recovery process.Moreover,the predictive models established based on the microbiome and metabolites of patients at the time of discharge reached high efficacy in predicting their neutralizing antibody levels one year later.Conclusions:This study is the first to characterize the oral and gut microbiome and metabonomics in 1-year convalescents of COVID-19.The key microbiome and metabolites in the process of recovery were identified,and provided new treatment ideas for accelerating recovery.And the predictive models based on the microbiome and metabolomics afford new insights for predicting the recovery situation which benefited affected individuals and healthcare.

运动疗法对产褥期妇女的康复作用

目的 探讨运动疗法对产褥期妇女康复的影响。方法选择150例产褥期妇女(治疗组)，产后24 h起做产后康复体操，产褥期满即产后42 d进行评定，另外，选择同期150例未做产后康复体操的产褥期妇女产后42 d进行对比评定(对照组)。结果治疗组的妇妇子宫后倾后屈、子宫脱垂的发生率比对照组明显低(P< 0.01);子宫缩复不良、痔疮、张力性尿失禁、膀胱膨出、腰骶痛的发生率均比对照组低(P< 0.05);腰围的恢复亦明显优于对照组(P< 0.05)。结论运动疗法有利于妇女产后康复，可减少诸多并发症的发生，从而提高产后妇女的生存质量。

Convalescent plasma: A potential therapeutic option for COVID-19 patients

The new coronavirus disease(COVID-19)outbreak has challenged us to take unprecedented steps to bring this pandemic under control.In view of the urgency of this situation,convalescent plasma which was used in previous coronavirus outbreaks has emerged as one of the treatment options in this current pandemic.This is mainly due to the fact that convalescent plasma has been studied in a few case series with promising outcomes.In addition,on-going large clinical trials aimed to further evaluate the effectiveness,safety,and optimal dosage,duration and timing of administration of convalescent plasma are indeed revealing a certain level of promising results.Therefore,this article aims to provide an overview of possible mechanisms of actions of convalescent plasma,its benefits and its level of usage safeness by summarizing the existing evidence on the use of convalescent plasma in COVID-19 patients.

Role of adjunctive treatment strategies in COVID-19 and a review of international and national clinical guidelines

The coronavirus disease(COVID-19)pandemic has led to a global struggle to cope with the sheer numbers of infected persons,many of whom require intensive care support or eventually succumb to the illness.The outbreak is managed by a combination of disease containment via public health measures and supportive care for those who are affected.To date,there is no specific anti-COVID-19 treatment.However,the urgency to identify treatments that could turn the tide has led to the emergence of several investigational drugs as potential candidates to improve outcome,especially in the severe to critically ill.While many of these adjunctive drugs are being investigated in clinical trials,professional bodies have attempted to clarify the setting where the use of these drugs may be considered as off-label or compassionate use.This review summarizes the clinical evidence of investigational adjunctive treatments used in COVID-19 patients as well as the recommendations of their use from guidelines issued by international and national organizations in healthcare.

FUNCTION OF SPA DEVELOPMENT IN COUNTRYSIDE FOR DOMESTIC TOURISM IN CHINA──A Case Study of Some Spas in Liaoning Province

The common problems on tourism of developing countries have often been researched by west researchers until now, which can be concluded into special words: "two sectors", "enclave construction", "government’s inteference", "developing scale", and "the industrial role of tourism" etc. In fact all the researches were done from the areas with the patronage of foreign visitors, how is the situation of domestic tourism was ignored in some points. In this paper, another developing model compatal with the one with foregn visitors was presented to the readers on the case studies of countryside spas in China. Through this research, one aspect of Chinese nd leisure life can be understood to some extent, and the implying that for bigger developing countries the domestic tourism can match the the effect of international tourism should not be ignored at least to China. As the developing of economy, domestic tourism will finally unile with international one together, and the common probleme will disappear step by step, there fre domestic tourism and international tourism of developing countries should be researched equally since now.

Melanin change of retinal pigment epithelium and choroid in the convalescent stage of Vogt-Koyanagi-Harada disease

AIM:To observe the melanin change of the retinal pigment epithelium(RPE)and choroid in the convalescent stage of Vogt-Koyanagi-Harada(VKH).METHODS:A retrospective study was performed on 40 eyes of 20 patients in the convalescent stage of VKH.Fundus photography(FP),multi-spectral imaging(MSI),and optical coherence tomography(OCT)were performed.RESULTS:In the VKH convalescent stage,focal RPE melanin accumulation(FRMA)was detected in 34 eyes(85%)on MSI and in 7 eyes(17.5%)on FP.FRMA was limited to the previous retinal detachment area in all 28 eyes(FRMA was detected in 34 eyes on MSI,which were enrolled,and 6 eyes lacked data in the acute stage).Sunset-glow fundus was detected in 20 eyes(50%)on FP.The mean density of FRMA in a 1-mm-diameter circular area of the fovea was 0.04±0.07 on MSI,which was significantly correlated with sunset-glow fundus(ρ=0.467,P=0.02).CONCLUSION:In the VKH convalescent stage,FRMA is derived from the RPE melanin change,and sunset-glow fundus is derived from the choroid melanin change.A higher density of FRMA in the fovea and sunset-glow fundus represents more serious depigmentation of melanin.

Understanding neutralising antibodies against SARS-CoV-2 and theirimplications in clinical practice

Severe acute respiratory syndrome coronavirus (SARS-CoV-2) is a newly identified member of the coronavirus family that has caused the coronavirus disease 2019 (COVID-19) pandemic. This rapidly evolving and unrelenting SARS-CoV-2has disrupted the lives and livelihoods of millions worldwide. As of 23 August 2021, a total of 211,373,303 COVID-19cases have been confirmed globally with a death toll of 4,424,341. A strong understanding of the infection pathway of SARS-CoV-2, and how our immune system responds to the virus is highly pertinent for guiding the development and improvement of effective treatments. In this review, we discuss the current understanding of neutralising antibodies(NAbs) and their implications in clinical practice. The aspects include the pathophysiology of the immune response,particularly humoral adaptive immunity and the roles of NAbs from B cells in infection clearance. We summarise the onset and persistence of IgA, IgM and IgG antibodies, and we explore their roles in neutralising SARS-CoV-2, their persistence in convalescent individuals, and in reinfection. Furthermore, we also review the applications of neutralising antibodies in the clinical setting—from predictors of disease severity to serological testing to vaccinations, and finally in therapeutics such as convalescent plasma infusion.

COVID-19 Pandemic: Its Origin, Implications and Treatments

This is a succinct and current review of pertinent literature to guide developing serum therapy as an emergent treatment to save human lives at times of natural or genetically engineered viral/bacterial pandemics. The origin of 2019-nCoV and implications of COVID-19 are discussed using direct quotes of published scientific literature to avoid misinterpretation on this very important event that has caused great loss of human lives and international social economy. It is the goal of this review to warn against and to correct international misunderstanding created by deliberate falsification of scientific documentations and events. This misunderstanding may lead to further destruction of life, economy, and political relations. People should not be blind-sighted when making life decisions.

Adipocytokine profile in children with Kawasaki disease at a mean follow-up period of 5.5 years: A study from North India

BACKGROUND Kawasaki disease(KD)is an acute self-limited vasculitis with a predilection for coronary arteries.Children with KD may have altered lipid metabolism and abnormal lipid profiles that may last for prolonged periods.However,there is a paucity of literature on the role of adipocytokines in KD.AIM To estimate the levels of adipocytokines(adiponectin,leptin and resistin)during the convalescent phase of KD.METHODS Twenty children,who had KD at least three years earlier,were enrolled in this study.In addition,20 healthy controls were also enrolled.Clinical and laboratory profiles of patients were obtained from hospital records.Serum adiponectin,leptin and resistin levels were estimated by enzyme-linked immunosorbent assay.RESULTS Mean age of the patients in the study group was 10.15±3 years and the male:female ratio was 1.5:1.Median serum resistin levels in patients with KD(27.77 ng/mL;[IQR:18.66,48.90])were decreased compared to controls(21.20 ng/mL;[IQR:14.80,27.00])(P=0.04).Median serum leptin levels in cases and controls were 1.83 ng/mL;(IQR:1.13,3.80),and 1.10 ng/mL;(IQR:0.41,2.88),respectively(P=0.09).Median serum adiponectin levels were similar in both cases(12.20μg/mL;[IQR:9.76,17.97])and controls(13.95μg/mL;[IQR:11.17,22.58]);(P=0.18).There was no significant difference in all 3 adipocytokines between children with(4/20)and without coronary artery abnormalities(16/20).CONCLUSION Serum resistin levels were significantly elevated in patients with KD during the convalescent phase compared to controls.Serum leptin levels appeared to be higher in patients with KD,although the difference was not statistically significant.Adiponectin levels were similar in both cases and controls.Raised resistin and leptin levels may partially explain lipid perturbations observed during the convalescent phase of KD.

Investigate Targeted Factors to Achieve Prediction Goal in Stroke Convalescence in Terms of Causal Relationships of Prediction Error

Background and Purpose: To investigate target functional independence measure (FIM) items to achieve the prediction goal in terms of the causal relationships between prognostic prediction error and FIM among stroke patients in the convalescent phase using the structural equation modeling (SEM) analysis. Methods: A total of 2992 stroke patients registered in the Japanese Rehabilitation Database were analyzed retrospectively. The prediction error was calculated based on a prognostic prediction formula proposed in a previous study. An exploratory factor analysis (EFA) then the factor was determined using confirmatory factorial analysis (CFA). Finally, multivariate analyses were performed using SEM analysis. Results: The fitted indices of the hypothesized model estimated based on EFA were confirmed by CFA. The factors estimated by EFA were applied, and interpreted as follows: “Transferring (T-factor),” “Dressing (D-factor),” and “Cognitive function (C-factor).” The fit of the structural model based on the three factors and prediction errors was supported by the SEM analysis. The effects of the D- and C-factors yielded similar causal relationships on prediction error. Meanwhile, the effects between the prediction error and the T-factor were low. Observed FIM items were related to their domains in the structural model, except for the dressing of the upper body and memory (p < 0.01). Conclusions: Transfer, which was not heavily considered in the previous prediction formula, was found in causal relationships with prediction error. It is suggested to intervene to transfer together with positive factors to recovery for achieving the prediction goal.

Advantages and Suggestions of Scraping to Promote Rehabilitation of COVID-19 Patients in Convalescence

Objective:To demonstrate the advantages of scraping in helping COVID-19 patients in convalescence,popularize scraping therapy among them and provide basis for the establishment of operation specification.Methods:Discuss the relationship between scraping and epidemic disease by reviewing the relevant scraping theory analysis,summarize the existing clinical studies and propose reference scheme for the treatment of COVID-19 patients in convalescence with respect to the related symptoms proving effective treatment of scraping on patients in convalescence.Results:Ancient healers used scraping to treat pestilence,and there have been many clinical trials and experiments for the treatment of convalescent symptoms related to scraping.Scraping also has the effect of improving immune function and antioxidation,which is feasible for the treatment of convalescent symptoms related to scraping.Conclusion:Scraping can effectively improve the clinical symptoms of COVID-19 convalescent patients,and it can be used as one of the external treatments for convalescent patients.It is recommended to promote scraping among the patients so that they can have self-intervention treatment.

Biopharmaceuticals for prevention of COVID-19:A scoping review

The COVID-19 epidemic caused by SARS-CoV-2 virus has turned into a worldwide pandemic.Therefore,health officials all around the world have strived for developing efficient preventive and treatment methods to deal with this global crisis.Amongst them,monoclonal antibodies,anti-TNFs,and convalescent plasma appear to be effective against this disease.In addition,clinical trials are currently being conducted for viral targeting vaccines.This review summarizes major advances using biopharmaceuticals in the treatment and prevention strategies against COVID-19 that have occurred in the global medicinal system from its introduction until March 2022.

Convalescent plasma as a therapeutic agent for SARS-CoV, MERS-CoV and SARS-CoV-2: A scoping review

Severe acute respiratory syndrome coronavirus(SARS-CoV),Middle East respiratory syndrome coronavirus(MERS-CoV),and SARS-CoV-2 are three kinds of coronaviruses that are exceptionally pathogenic to humans via zoonotic infections.The outbreaks of SARS-CoV and MERS-CoV,and SARS-CoV-2,to some extent,posed a severe threat to human health,daily activities as well as the economic status of many countries.When faced with these emerging viruses and no accessible vaccines and drugs,convalescent plasma(CP)is required as passive immunotherapy,since CP has the potential to neutralize and eliminate the virus from blood circulation.The sources of CP are individuals who have recovered from the viruses.Currently,CP is administered as emergency use and investigational treatment.Some studies have shown that CP is effective to treat infected individuals with viral pandemics such as influenza A,Ebola virus,SARS-CoV,and MERS-CoV.Moreover,following the deadly outbreak of SARS-CoV-2 in 2019,plenty of non-randomized clinical studies have been done on the effectiveness of CP for the treatment of Coronavirus Disease 2019(COVID-19),and most of these studies have indicated that CP therapy is promising and saved many critically-ill patients.Therefore,CP is a helpful immune therapeutic agent for the immediate response of such pandemics because of its clinical efficacy,immediate availability,cost-effectiveness,ease of production,delivery,and storage.This review aims to summarize the effectiveness of CP in the treatment of these three coronaviruses,i.e.SARS-CoV,MERS-CoV,and SARS-CoV-2.

Timing of convalescent plasma therapy-tips from curing a 100-yearold COVID-19 patient using convalescent plasma treatment: A case report

BACKGROUND Convalescent plasma therapy is used for the treatment of critically ill patients for newly discovered infectious diseases,such as coronavirus disease 2019(COVID-19)pneumonia,under the premise of lacking specific treatment drugs and corresponding vaccines.But the best timing application of plasma therapy and whether it is effective by antiviral and antibiotic treatment remain unclear.CASE SUMMARY We describe a patient with COVID-19,a 100-year-old,high-risk,elderly male who had multiple underlying diseases such as stage 2 hypertension(very high-risk group)and infectious pneumonia accompanied by chronic obstructive pulmonary disease and emphysema.We mainly describe the diagnosis,clinical process,and treatment of the patient,including the processes of two plasma transfusion treatments.CONCLUSION This provides a reference for choosing the best timing of convalescent plasma treatment and highlights the effectiveness of the clinical strategy of plasma treatment in the recovery period of patients with COVID-19 pneumonia.

Low-grade fever during COVID-19 convalescence:A report of 3 cases

BACKGROUND Low-grade fever during convalescence is an atypical symptom of coronavirus disease 2019(COVID-19).Reports of such cases are rare,and the mechanism and outcome of low-grade fever during COVID-19 convalescence are not completely clear.We report 3 cases with low-grade fever during COVID-19 convalescence and highlight the main clinical,radiographic,and laboratory characteristics,thereby increasing the level of expertise in the clinical management of COVID-19 during convalescence and facilitating individualized decision-making.CASE SUMMARY We describe 3 patients with COVID-19,two females aged 62 and 66 years and a male 55 years,who had low-grade fever during COVID-19 convalescence.All 3 patients had no other discomfort or comorbidities during low-grade process.Lesions on computed tomography in all 3 patients had resolved during this period.Two patients tested negative on two consecutive severe acute respiratory syndrome coronavirus 2 tests with an interval of at least 24 h between tests.Body temperature in all 3 patients returned to normal after several days without treatment,and fever recurrence was not observed.CONCLUSION Enhancing the knowledge of low-grade fever during COVID-19 convalescence may increase the expertise in the delivery of optimal healthcare services.

Successful recovery of COVID-19-associated recurrent diarrhea and gastrointestinal hemorrhage using convalescent plasma

Background: Gastrointestinal symptoms are not rare among coronavirus disease 2019(COVID-19) patients, but there have been no reports regarding convalescent plasma therapy for the recovery of gastrointestinal problems in COVID-19 patients.Case presentation: We present two cases of patients with COVID-19-associated recurrent diarrhea and positive fecal occult blood who successfully recovered after a one-time convalescent plasma administration.Conclusion: When COVID-19 patients develop recurrent or refractory gastrointestinal symptoms and fail to respond to the available treatment, alternative therapy with convalescent plasma administration may be considered.

Clinical Observation in 31 Cases of Chronic Bronchitis at Remission Stage Treated with Bufei Keli

To observe the therapeutic effects of a Chinese drug Bufei Keli (补肺颗粒 granules for invigorating the lung) in the treatment of chronic bronchitis at remission stage, 62 cases were randomly divided into a treatment group (treated with Bufei Keli) and a control group (treated with Yupingfeng Keli 玉屏风颗粒). The results turned out to be that the short-term clinically controlled and markedly effective rate was 77.42% and the long-term relapse-resisting markedly effective rate was 74.2% in the treatment group, which were obviously higher than 45.16% and 38.71% respectively in the control group (P<0.05). And the increase in contents of SOD and CD_3 and the decrease in LPO content in the treatment group were also bigger than that in the control group (P<0.01). It is therefore concluded that Bufei Keli can improve qi deficiency syndrome and raise the immunity of patients with chronic bronchitis, hence its effect of resisting relapse of chronic bronchitis.

Convalescent plasma therapy in a pregnant COVID-19 patient with a dramatic clinical and imaging response: A case report

BACKGROUND Coronavirus disease 2019(COVID-19)is a novel very contagious infection which was designated a pandemic in all countries of the world in April 2020.Its presentation varies from mild to severe infection,but the majority of infected patients have mild manifestations.Many therapeutic choices have been suggested to treat the infection,but none are fully effective.CASE SUMMARY Herein we present a 26-year-old woman with a twin pregnancy at 36 wk and one day gestation with confirmed COVID-19 who responded dramatically to convalescent plasma therapy(CPT)and Favipiravir.CONCLUSION Although this case report shows the efficacy of CPT in addition to usual medications used for COVID-19,there are many questions that need to be answered regarding dosage,para-clinical efficacy,side effects and combination therapy.